Aggregate Claims

Aggregate claims are processed in our Minnesota office. Claims can be submitted by mail.

Required to Process Aggregate Claims

The following items are required to process aggregate claims.

Aggregate Claim Request Form

·       Paid Claims Report for the policy period.

·       Check Register for the policy period.

·       Monthly Premium Billing Statements for the policy period, and three months after the policy period has ended to account for retro additions and terminations.

·       Eligibility Report to include all active and terminated employees for the policy period.

·       A report listing those individuals who have exceeded 50% of the Specific Deductible.

·       Copies of Bank Statements for the policy period and one month after the policy period has ended.

·       A report showing all Voids and Refunds for those claims originally processed during the policy period, but received and/or processed after the policy period has ended.  If the detailed paid claims report does not include voids and refunds processed during the policy period, it should be included in the report also.

·       A listing of all Outstanding Overpayments for claims paid during the policy period.

·       Prescription Drug Invoices and corresponding detail for claims paid during the policy period.

·       Benefit or Coverage Report to identify all out-of-contract payments.

·      Aggregate Report that includes the census figures used to calculate the attachment point.

·       A list of outstanding Subrogation Claim